Vitamin D 28 ( deficiency <50, Insufficient 50-75, Adequate >75)
GP has just prescribed monthly loading gel Altavita capsule of 25,000ui, one capsule a month for 6 months. Is this correct? From my reading of other posts this is very low, but I am not sure.
Loading doses should total 280,000 - 300,000iu over a period of time, usually between 6 and 10 weeks - see cks.nice.org.uk/vitamin-d-d...
Don't forget the important cofactors, particularly K2-MK7 and magnesium
vitamindcouncil.org/about-v...
Thank you SeasideSusie, Unfortunately I can't see the nice.org.uk document: it says I am outside the uk.
I don't have the strength of will to go back to the gp yet again. I have only just persuaded the gp to increase my levo to 50mg, and had to argue to get that. I was not surprised I had to fight to get a prescription for vitamin d. I thought she had prescribed 250,000 rather than 25,000.
So I intend to take the month dose, and supplement further.
So if I take the 25,000 ui, today, and another in 4 weeks time, that would be 50,000, so by my calculations to reach loading doses, over the 8 weeks, I should be taking an extra 250,000 spread out over the 8 weeks (56days) , so a daily extra intake of 4000ui a day???
Does that sound right?
I had already bought vit d3 1000, with k2 75mg, so if I took 4 of these a day, I should be ok I think. I hope I am doing the right thing.
This is what the NICE Clinical Knowledge Summary says:
NICE treatment summary for Vit D deficiency:
cks.nice.org.uk/vitamin-d-d...
"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Personally, I would keep it simple and follow one of the dosages in the Summary. You have 25,000iu capsules. Why not take one a week for 12 weeks which will total 300,000. If you don't have enough you can easily buy D3 softgels to top up. Once you've taken the 300,000iu I would retest.
The Vit D Council recommends a level of 100-150nmol/L so if you've not reached this level on your retest then take 5000iu daily until you do. Come back and post on the forum with your new level if you want to know how long to dose with 5000iu for (link back to this post or give full information). Once you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
You can use up your D3 1000iu at a later date when you're on your maintenance dose.
If your D3 1000iu contains 75mcg K2 in the same capsule then you shouldn't take 4 of them at once. K2 only needs to be 90-100mcg for up to 10,000iu D3.
There are important cofactors needed when taking D3
vitamindcouncil.org/about-v...
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
naturalnews.com/046401_magn...
Check out the other cofactors too.
Looks like I am going to have to source different vitamin d supplement. I have only one 25,000 capsule, the doctor prescribed one a month, for six months, I cannot get another capsule from the pharmacist until next month!!!!!!! Are you able to tell me where I might be able to get more capsules online, as the pharmacy can not give them to me?
Thank you for the warning about the K2.
Is there a multivitamin that would have the K2, Magnisium and other cofactors in the right levels whilst taking the loading doses of vit d?
Sorry for firing so many questions at you, you do seem to know about these things!
I think the most cost effective way is to buy 5000iu softgels. There are 10,000iu ones but it works out more expensive and you don't really need more than 30. So go for the 5000iu ones and you can take 2 a day for as long as you need the 10,000iu then you'll have the right strength to drop straight down to 5000iu or even alternate days which might be near your maintenance dose.
Softgels are best because they contain olive oil to aid absorption, but still take with some dietary fat such as a full fat yogurt, toast with butter, a meal with some fat.
dolphinfitness.co.uk/en/doc... (best value)
dolphinfitness.co.uk/en/now...
I have used both these brands, they are excellent and only contain D3 and olive oil. They are very small softgels so no problem getting them down. I use this supplier and they are excellent. But the supplier below also has the Doctors Best brand so compare prices (remember to factor in postage).
You wont find a supplement with all the cofactors in, you will need to buy them separately.
K2-MK7 - bigvits.co.uk/product.php?p... (cheaper than Amazon)
D3 - bigvits.co.uk/product.php?p...
Magnesium you will have to decide which form is best for you and do some comparisons.
Don't start them all at once. Start with D3 and leave it 2 weeks. If no problems then add in the K2 and leave it another 2 weeks, if no problems add in the magnesium.
Thank you that is so helpful, I have ordered online and hope they arrive sometime this week. I will get my vit d levels checked again as you suggested after taking the 300,000iu.
Thank you.
Just found this information which does suggest the level of supplementing is too low. So can someone advise me what to do ?
Altavita D3 25,000 IU soft capsules & Altavita 25,000 IU oral solution: Adults: Prevention of deficiency, 25,000 IU/month (1 capsule or single dose oral solution); higher doses and monitoring of serum 25(OH)D may be required in populations at high risk of vitamin D deficiency (* see below) Adjunct to specific therapy for osteoporosis, 25,000 IU/month (1 capsule or single dose oral solution). Treatment of deficiency (<25 nmol/L), 50,000 IU/week (2 capsules or single dose oral solution) for 6-8 weeks followed by maintenance therapy 1,400 – 2,000 IU/day, may be required such as 2 capsules or oral solutions per month; follow-up 25(OH)D measurements should be made approximately 3-4 months after initiating maintenance therapy to confirm that the target level has been achieved.
If you don't have any other medical conditions like kidney disease or high blood pressure, so you are on calcium channel blockers, then go back to the GP and politely but firmly show him/her a copy of the information you have found. Ask for your prescription to be changed.
Yes it will be hard to stand up for yourself in front of some patronising GPs but you are going to have to as many GPs get vitamin D therapy wrong out of ignorance as some think all this testing and supplementation is a fad. Monthly doses aren't actually recommended for any one as research has shown that the absorption rate is poor and that older people are more prone to falls having such doses.
If s/he refuses to budge then buy some 5,000IU capsules and take 2 per day for 8-10 weeks then one every other day. (The co-factors may help to decrease side effects especially at the beginning like bone pain as well as ensuring you are sufficient in those nutrients.)
At 6 months you MUST make sure you get your vitamin D level tested. Too much vitamin D is as bad as too little so if the NHS refuses to do a retest you can get it done through City Assays for £28.
There is no point testing vitamin D levels at more than 3 month intervals - if you are deficient and take 10,000IU per day as a loading dose unless you are also in the sun for hours as well you aren't going to increase your vitamin D levels that quickly in a month. You can also decide to test more frequently than 6 months but the NHS normally retests adults at 6 months and children at 3 months. This is because vitamin D deficiency leads to adverse growth defects in babies/children and can also lead to their death.
Btw expect to buy your own maintenance dose as the NHS frequently only gives people 800IU capsules. Lots of people who have deficiency problems need to take 1,000IU+ per day for the rest of their lives. Also you will have to pay to retest your self once a year. If your GP is honest and open they will say the NHS can't afford it but most fudge answering you, and it is nurses who openly say this.
Thank you bluebug, having just fought my gp to increase my levo from 25 to 50mg, despite "normal" (haha!) levels. I have not got the strength to fight for this as well. I think I will take the monthly dose she has given me and take an additional 4000ui per day for the next 8 weeks. I think this will work out to the equivalent of loading doses.
Because I live in Ireland I already have to pay for vitamin d blood tests. But it is good to know that 6 monthly is a reasonable timeframe for going back to retest to check my levels, thank you.
It depends on your other conditions for example if you have kidney disease . My endo prescribed D3 drops 20,000 iu a week but we all differ so best to check your renal function out. Sorry for the rushed reply..
Taking it daily can be better absorbed than large doses weekly ... I have read.
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